To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Internationally, stresses related to the COVID-19 pandemic negatively affected the mental health of family caregivers of adults with intellectual and developmental disabilities (IDDs).
Aims
This cross-sectional study investigated demographic, situational and psychological variables associated with mental wellbeing among family caregivers of adults with IDDs during the COVID-19 pandemic.
Method
Baseline data from 202 family caregivers participating in virtual courses to support caregiver mental well-being were collected from October 2020 to June 2022 via online survey. Mental well-being was assessed using total scores from the Warwick-Edinburgh Mental Wellbeing Scale. Demographic, situational and psychological contributors to mental well-being were identified using hierarchical regression analysis.
Results
Variables associated with lower levels of mental well-being were gender (women); age (<60 years old); lack of vaccine availability; loss of programming for their family member; social isolation; and low confidence in their ability to prepare for healthcare, support their family member's mental health, manage burnout and navigate healthcare and social systems. Connection with other families, confidence in managing burnout and building resilience and confidence in working effectively across health and social systems were significant predictors of mental well-being in the final regression model, which predicted 55.6% of variance in mental well-being (P < 0.001).
Conclusions
Family caregivers need ways to foster social connections with other families, and support to properly utilise healthcare and social services during public health emergencies. Helping them attend to their needs as caregivers can promote their mental health and ultimately improve outcomes for their family members with disabilities.
The study determined the prevalence and genetic population structure relationships of Cysticercus tenuicollis (Taenia hydatigena metacestode) retrieved from the goats slaughtered in north India. An overall prevalence of 9.62% (59/613) was recorded. Genetic population structure relationships were assessed by targeting partial cytochrome c oxidase subunit 1 mitochondrial gene sequence. Phylogenetic tree analysis revealed that all the present study representative isolates (n = 7) formed a major clade and grouped with T. hydatigena isolates retrieved from sheep, goats, pigs and dogs, originating from China, Iran, Nigeria, Ghana and Poland. However, a single isolate from Himachal Pradesh (isolate 3) formed a subgroup within the clade. The neutrality and diversity indices revealed high values of haplotype diversity [Hd = 0.99695 (0.95238–1.0000)] and low nucleotide diversity (π = 0.49276), which was indicative of demographic expansion and low gene flow, suggesting that Indian T. hydatigena isolates were not genetically differentiated. Tajima's D (−1.26988) and Fu and Li's D statistics values (−0.74556) were negative, demonstrating deviations from neutrality and both propounded recent population expansion or purifying selection. Results highlighted a low genetic diversity of T. hydatigena metacestodes across the geographical range of north India.
Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D2 and vitamin D3, both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 μg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 μg for those aged 1–70 years and 20 μg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.
To assess the effect of tranexamic acid in head and neck surgical procedures.
Methods
A prospective, double-blind and randomised, parallel group, placebo-controlled clinical trial was conducted. Ninety-two patients undergoing various head and neck surgical procedures were randomised. Subjects received seven infusions of coded drugs (tranexamic acid or normal saline) starting at the time of skin closure. Haematological, biochemical, blood loss and other parameters were observed by the staff, who were blinded to patients’ group allocation (case or control).
Results
Patients were analysed on the basis of type of surgery. Fifty patients who had undergone surgical procedures, including total thyroidectomy, total parotidectomy, and various neck dissections with or without primary tumour excision, were included in the first group. The second group comprised 41 patients who had undergone hemithyroidectomy, lobectomy or superficial parotidectomy. There was no statistical difference in blood parameters between both groups. There was a reduction in post-operative drain volume, but this was not significant.
Conclusion
Although this prospective, randomised, placebo-controlled clinical trial found a reduction in post-operative drain volume in tranexamic acid groups, the difference was not statistically significant between the various head and neck surgical procedure groups.
Background: Biallelic variants in POLR1C are associated with POLR3-related leukodystrophy (POLR3-HLD), or 4H leukodystrophy (Hypomyelination, Hypodontia, Hypogonadotropic Hypogonadism), and Treacher Collins syndrome (TCS). The clinical spectrum of POLR3-HLD caused by variants in this gene has not been described. Methods: A cross-sectional observational study involving 25 centers worldwide was conducted between 2016 and 2018. The clinical, radiologic and molecular features of 23 unreported and previously reported cases of POLR3-HLD caused by POLR1C variants were reviewed. Results: Most participants presented between birth and age 6 years with motor difficulties. Neurological deterioration was seen during childhood, suggesting a more severe phenotype than previously described. The dental, ocular and endocrine features often seen in POLR3-HLD were not invariably present. Five patients (22%) had a combination of hypomyelinating leukodystrophy and abnormal craniofacial development, including one individual with clear TCS features. Several cases did not exhibit all the typical radiologic characteristics of POLR3-HLD. A total of 29 different pathogenic variants in POLR1C were identified, including 13 new disease-causing variants. Conclusions: Based on the largest cohort of patients to date, these results suggest novel characteristics of POLR1C-related disorder, with a spectrum of clinical involvement characterized by hypomyelinating leukodystrophy with or without abnormal craniofacial development reminiscent of TCS.
Propagation of a strong incident shock through a bed of particles results in complex wave dynamics such as a reflected shock, a transmitted shock, and highly unsteady flow inside the particle bed. In this paper we present three-dimensional numerical simulations of shock propagation in air over a random bed of particles. We assume the flow is inviscid and governed by the Euler equations of gas dynamics. Simulations are carried out by varying the volume fraction of the particle bed at a fixed shock Mach number. We compute the unsteady inviscid streamwise and transverse drag coefficients as a function of time for each particle in the random bed for different volume fractions. We show that (i) there are significant variations in the peak drag for the particles in the bed, (ii) the mean peak drag as a function of streamwise distance through the bed decreases with a slope that increases as the volume fraction increases, and (iii) the deviation from the mean peak drag does not correlate with local volume fraction. We also present the local Mach number and pressure contours for the different volume fractions to explain the various observed complex physical mechanisms occurring during the shock–particle interactions. Since the shock interaction with the random bed of particles leads to transmitted and reflected waves, we compute the average flow properties to characterize the strength of the transmitted and reflected shock waves and quantify the energy dissipation inside the particle bed. Finally, to better understand the complex wave dynamics in a random bed, we consider a simpler approximation of a planar shock propagating in a duct with a sudden area change. We obtain Riemann solutions to this problem, which are used to compare with fully resolved numerical simulations.
Central nervous system infections (CNSI) are a leading cause of death and long-term disability in children. Using ICD-10 data from 2005 to 2015 from three central hospitals in Ho Chi Minh City (HCMC), Vietnam, we exploited generalized additive mixed models (GAMM) to examine the spatial-temporal distribution and spatial and climatic risk factors of paediatric CNSI, excluding tuberculous meningitis, in this setting. From 2005 to 2015, there were 9469 cases of paediatric CNSI; 33% were ⩽1 year old at admission and were mainly diagnosed with presumed bacterial CNSI (BI) (79%), the remainder were >1 year old and mainly diagnosed with presumed non-bacterial CNSI (non-BI) (59%). The urban districts of HCMC in proximity to the hospitals as well as some outer districts had the highest incidences of BI and non-BI; BI incidence was higher in the dry season. Monthly BI incidence exhibited a significant decreasing trend over the study. Both BI and non-BI were significantly associated with lags in monthly average temperature, rainfall, and river water level. Our findings add new insights into this important group of infections in Vietnam, and highlight where resources for the prevention and control of paediatric CNSI should be allocated.
To assess cardiac functions in adenotonsillar or tonsillar hypertrophy.
Methods:
A prospective, interventional, academic centre based study was conducted on 25 children with adenotonsillar or tonsillar hypertrophy. All patients underwent pulsed 2-dimensional Doppler echocardiography, pulse oximetry and 12-lead electrocardiography. These assessments were repeated three months later to determine the impact of adenotonsillectomy.
Results:
There were significant differences in mean arterial oxygen saturation, pulmonary flow acceleration time and mean pulmonary artery pressure post-operatively. Adenotonsillectomy led to significant improvements in pulmonary flow acceleration time and pulmonary flow velocity time index, while tonsillectomy resulted in right ventricular early and late diastolic velocity index improvement.
Conclusion:
Upper airway obstruction in children affects cardiac functioning and this can subsequently lead to morbidity and delayed growth. Hence, revision of surgical indications is advocated in adenotonsillar hypertrophy to avoid irreversible damage to cardiopulmonary functions.
Bovine viral diarrhea virus (BVDV) has long been associated with a wide variety of clinical syndromes and immune dysregulation, many which result in secondary bacterial infections. Current understanding of immune cell interactions that result in activation and tolerance are explored in light of BVDV infection including: depletion of lymphocytes, effects on neutrophils, natural killer cells, and the role of receptors and cytokines. In addition, we review some new information on the effect of BVDV on immune development in the fetal liver, the role of resident macrophages, and greater implications for persistent infection.
Facets of Social Geography: International and Indian Perspectives provides a breadth of information on the nature, scope, history and evolution of social geography along with a good representation of approaches and techniques used in this field. It discusses both conceptual and empirical approaches, and traditional and emergent social geography themes including art and culture, urbanism and crime, social institutions of caste, class and religion, gender, disability, activism, feminism, social planning, enterprise zones, social and economic inequities, post-colonialism, post-modernism and development of quantitative, qualitative and mixed methods. India's social structure based on centuries-old Karma principles and a four-level caste system are dealt with in this book to help unravel the country's social geography. This book is a felicitation volume in honour of Allen G. Noble, Distinguished Professor Emeritus of Geography and Planning at the University of Akron, Ohio, USA. A result of the collective effort of 40 leading national and international scholars, it is an excellent addition to the current stock of knowledge and will be of interest to geographers, sociologists, demographers, urban and regional planners and policy-makers.
Edited by
Ashok K. Dutt, Professor Emeritus in Geography, Planning and Urban Studies, University of Akron, USA,Vandana Wadhwa, Lecturer in the Department of Geography and Environment at Boston University, Massachusetts,Baleshwar Thakur, Former Head of the Department of Geography, Delhi School of Economics, University of Delhi,,Frank J. Costa, Professor Emeritus in Geography, Planning, Urban Studies and Public Administration at the University of Akron, USA.
I claim that human mind or human society is not divided into watertight compartments called social, political and religious. All act and react upon one another.
Mohandas Karamchand Gandhi
Although it may be possible to distinguish the various streams that comprise Social Geography, these fluid currents flow together to create a vast body of inter-and-intra-disciplinary study. This book attempts to capture the holistic essence of this field as well as highlight its rich thematic and areal diversity. Organized society and its institutions and characteristics over space go back to prehistoric times. It is no surprise then, that the field of social geography presents a full panoply of subjects of study.
Since its establishment as a recognized sub-field of geography in the twentieth century, Social Geography has continuously evolved to reflect the changing socioeconomic and political climate. Thus, the birth of radical geographies of feminism, the increased volume of alternate voices of transnationalism, postcolonialism and emerging geographies, the embracing of postmodernist methodologies and tools of interpretivism, the adoption of Geographic Information Systems (GIS) and remote sensing techniques to tackle social themes of study and so on. Such rapid changes necessitate the need for revisiting the state of the field every so often, while maintaining a connection with its traditional roots and themes.
Therein lies the significance of this book. The current work presents a number of contributions that provide an overview of the works that laid the foundation for Social Geography, or themselves address some of the traditional themes in Social Geography, such as art and culture, urbanism and crime, and social institutions of caste, class, and religion.
Edited by
Ashok K. Dutt, Professor Emeritus in Geography, Planning and Urban Studies, University of Akron, USA,Vandana Wadhwa, Lecturer in the Department of Geography and Environment at Boston University, Massachusetts,Baleshwar Thakur, Former Head of the Department of Geography, Delhi School of Economics, University of Delhi,,Frank J. Costa, Professor Emeritus in Geography, Planning, Urban Studies and Public Administration at the University of Akron, USA.
Edited by
Ashok K. Dutt, Professor Emeritus in Geography, Planning and Urban Studies, University of Akron, USA,Vandana Wadhwa, Lecturer in the Department of Geography and Environment at Boston University, Massachusetts,Baleshwar Thakur, Former Head of the Department of Geography, Delhi School of Economics, University of Delhi,,Frank J. Costa, Professor Emeritus in Geography, Planning, Urban Studies and Public Administration at the University of Akron, USA.
Edited by
Ashok K. Dutt, Professor Emeritus in Geography, Planning and Urban Studies, University of Akron, USA,Vandana Wadhwa, Lecturer in the Department of Geography and Environment at Boston University, Massachusetts,Baleshwar Thakur, Former Head of the Department of Geography, Delhi School of Economics, University of Delhi,,Frank J. Costa, Professor Emeritus in Geography, Planning, Urban Studies and Public Administration at the University of Akron, USA.
Edited by
Ashok K. Dutt, Professor Emeritus in Geography, Planning and Urban Studies, University of Akron, USA,Vandana Wadhwa, Lecturer in the Department of Geography and Environment at Boston University, Massachusetts,Baleshwar Thakur, Former Head of the Department of Geography, Delhi School of Economics, University of Delhi,,Frank J. Costa, Professor Emeritus in Geography, Planning, Urban Studies and Public Administration at the University of Akron, USA.
Edited by
Ashok K. Dutt, Professor Emeritus in Geography, Planning and Urban Studies, University of Akron, USA,Vandana Wadhwa, Lecturer in the Department of Geography and Environment at Boston University, Massachusetts,Baleshwar Thakur, Former Head of the Department of Geography, Delhi School of Economics, University of Delhi,,Frank J. Costa, Professor Emeritus in Geography, Planning, Urban Studies and Public Administration at the University of Akron, USA.